| Trexler et al. (2010)
USA
RCT
PEDro=5
NInitial=22, NFinal=20 |
Population: TBI=7, ABI=7, Stroke=6, Other=2; Gender: Male=14, Female=8.
Intervention: Patients were randomly assigned to a resource facilitation program (treatment, n=9) or standard care (control, n=11). The treatment group was assigned a resource facilitator with the goal of returning to work.
Outcome Measures: Return to work, Participation Index of the Mayo Portland Adaptability Inventory (M2PI), Patient Health Questionnaire (PHQ-9). |
1. Participation increased for both groups over the course of treatment (p<0.0001).
2. The interaction between group and time indicated greater improvement in the treatment group (p=0.007), showing a strong impact on return to work and community participation.
3. Employment was achieved by 64% of the treatment group compared to 36% of controls (p<0.0001).
4. No significant differences between groups were found on the PHQ-9. |
| Radford et al. (2013)
United Kingdom
PCT
Ninitial=94, Nfinal=79 |
Population: TBI; Mean Age=34.3yr; Gender: Male=63, Female=16; Severity: Mild=40, Moderate=16, Severe=38.
Intervention: Patients were assigned to vocational rehabilitation with a resource facilitator (treatment, n=34) or usual care (control; n=45). Outcomes were assessed at 3, 6, and 12 mo.
Outcome Measure: Return to work. |
1. At each time point, a greater percentage of the treatment group returned to work or school compared to the controls.
2. At 1yr, 75% of the treatment group returned to work compared to 60% of the controls.
3. 13 of 14 patients with ‘minor’ TBI in the treatment group returned to work by 3mo compared to 14 of 25 in the control group (p=0.03). |
| Trexler & Parrott (2018)
USA
Cohort
NInitial=243, NFinal=243
|
Population: TBI=171; Treatment Group (n=210): Mean Age=38.32±13.28yr; Gender: Male=142, Female=68; Mean Time Post Injury=9.61yr, Severity: Mild=2, Moderate-to-Severe=152
Control Group (n=34): Mean Age=40.30±11.54yr, Gender: Male=21, Female=12; Mean Time Post Injury=0.18yr; Severity: Mid=0, Moderate-to-Severe=17.
Intervention: Participants were prospectively followed to compare the effectiveness of a Resource Facilitation (RF) program to standard vocational rehabilitation. The RF program focuses on improving return to work by providing individualized treatment that helps to connect patients and caregivers with community-based resources and services, preventing barriers to return to work. Outcome measures were assessed 90d after the participants became competitively employed.
Outcome Measures: Return to either part- or full-time competitive work or post-secondary school, Mayo-Portland Adaptability Inventory-4 (MPAI-4). |
1. The sample population was derived from two different data sources, 210 from clinical patients discharged from the RF program and 33 from a RCT control group that did not receive RF.
2. As a result, the inclusion criteria varied between groups and a significant difference between the two groups was present at baseline:
· Years post injury (p<.05)
· Age at injury (p<.05)
· Injury type (p<.05)
3. Of those that completed the intervention, 69% successfully returned to work, while 48% in the control group returned to work.
4. A significantly greater proportion of the treatment group obtained employment than the control group (p = .018).
5. An unknown portion of the sample reported work hours and type of employment gained.
· Most participants worked part time, while 36% were able to work full-time.
· Almost half of participants retuned to administrative support or laborer positions.
6. Treatment group significantly predicted employment outcome when controlling for baseline levels of disability (p = .033) |
